含全身放疗方案与白消安方案预处理治疗复发/难治急性髓系白血病疗效的对比分析  

Comparative Analysis of Pretreatment with Total Body Irradiation Containing RegimenVersus Busulphan Containing Regimen for Relapsed/Refractory Acute Myeloid Leukemia

作　　者：刘圆圆 费新红[1] 张书芹[1] 温红霞 王静波[1] LIU Yuanyuan;FEI Xinhong;ZHANG Shuqin;WEN Hongxia;WANG Jingbo(Department of Hematology,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院血液科,北京100049

出　　处：《河南医学研究》2021年第18期3288-3292,共5页Henan Medical Research

摘　　要：目的探讨含全身放疗预处理方案与含白消安预处理方案治疗复发/难治急性髓系白血病的疗效对比。方法回顾分析航天中心医院2012年5月至2017年12月进行异基因造血干细胞移植的135例复发/难治的急性髓系白血病,其中69例接受清髓的全身放疗方案(TBI-MAC)预处理,66例接受清髓的白消安方案(BU-MAC)预处理。对两组患者移植后合并症及复发率、非复发死亡率、无病生存率及总生存率进行比较。结果中位随访时间为20(4~68)个月。两组患者移植后急、慢性移植物抗宿主病(GVHD)的发生率差异无统计学意义(P>0.05),巨细胞病毒和EB病毒的发生率差异无统计学意义(P>0.05)。移植后2 a复发率TBI-MAC组为(47.7±7.1)%、BU-MAC组为(46.9±9.3)%;非复发死亡率TBI-MAC组为(25.0±6.3)%,BU-MAC组为(22.4±6.0)%,两组间比较,差异无统计学意义(P>0.05);无病生存率TBI-MAC组为(41.1±6.0)%,BU-MAC组为(38.5±6.6)%;总生存率TBI-MAC组为(42.3±6.1)%,BU-MAC组为(42.2±7.0)%,两组间比较,差异无统计学意义(P>0.05)。结论含全身放疗清髓预处理方案可以作为复发/难治急性髓系白血病AML的一个替代治疗方案。Objective To investigate the efficacy of pretreatment regimen containing total body irradiation compared with pretreatment regimen containing busulphan for relapsed/refractory acute myeloid leukemia.Methods One hundred and thirty-five cases of relapsed/refractory acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation in Aerospace Center Hospital from May 2012 to December 2017 were retrospectively analyzed,including 69 cases patients who received total body irradiation-myeloablative conditioning regimen(TBI-MAC),and 66 cases patients who received Busulfan-myeloablative conditioning regimen(BU-MAC).Complications,relapsed rate,non-relapsed mortality rate,disease-free survival rate and overall survival rate were compared between the two groups.Results The median follow-up time was 20(4-68)months.There were no statistical differences in the incidence rates of acute and chronic graft-versus-host disease(GVHD)between the two groups(P>0.05).The incidence rates of cytomegalovirus(CMV)and EB virus had no statistical differences(P>0.05).Two years after transplantation,the relapsed rate of TBI-MAC was(47.7±7.1)%,and the relapsed rate of BU-MAC was(46.9±9.3)%.The non-relapsed mortality rate of TBI-MAC was(25.0±6.3)%,and the non-relapsed mortality rate of BU-MAC was(22.4±6.0)%.There were no statistical differences between the two groups(P>0.05).The disease-free survival rate of TBI-MAC was(41.1±6.0)%,and the disease-free survival rate of BU-MAC was(38.5±6.6)%.The overall survival rate of TBI-MAC was(42.3±6.1)%,and the overall survival rate of BU-MAC was(42.2±7.0)%.There were no statistical differences between the two groups(P>0.05).Conclusion Total body irradiation conditioning regimen can be used as an alternative treatment for relapsed or refractory acute myeloid leukemia(AML).

关 键 词：全身放疗 白消安 移植预处理 急性髓系白血病 造血干细胞移植 

分 类 号：R552[医药卫生—血液循环系统疾病]